Skip navigation | Skip to footer
 

More Government action needed to help 2 million unable to find NHS dentist, says Citizens Advice

28 March 2007

More Government action is needed to deal with ‘dentistry deserts’ and reduce the figure of two million people unable to find an NHS dentist, says national charity Citizens Advice. The figure is the Government’s own estimate from April 2006 of people in England who want to access NHS dentistry but are unable to do so. A report published today by Citizens Advice shows patients still face huge problems finding a dentist. Latest Government statistics published last week show no increase in the percentage (55.7%) of people receiving dental treatment in the first nine months of the reforms. *

The report, called Gaps to Fill, shows there is still huge inequality in access to NHS dentistry, with some areas such as Hartlepool and Hornchurch spoilt for choice and others including Blackburn and Petersfield with very poor access. People in rural communities such as Cornwall, Cheshire and North Wales are particularly disadvantaged if they rely on public transport, forcing them to take expensive, difficult and time-consuming journeys to reach a dentist.

The charity says that Government reforms introduced a year ago are not yet bringing equal access to NHS dentistry in England and Wales, and that only additional funding will really help the communities with poorest access to NHS dentistry.

More than 4,000 people completed a survey on the Citizens Advice website New windowwww.adviceguide.org.uk. Two-thirds of people who responded said they ended up going without any treatment due to huge problems accessing NHS dentistry and not being able to pay for expensive private treatment.  In the survey;

* (percentages don’t add up to 100 as people could give more than one answer)

Patients have reported having to do round-trips as long as 120 miles to reach an NHS dentist.

One survey respondent from Cornwall said, ”the nearest NHS dentists are too far away to reach, involving a whole day away and taking my 6-year-old daughter out of school for a whole day just to get her to a dentist.”

There is no financial help for people on low incomes who are forced to travel to reach an NHS dentist. Citizens Advice is recommending that the Hospital Travel Costs Scheme should be extended to include help with travel costs to NHS dentistry appointments.

One survey respondent said;

"I am a mother living on income support with three children. Our NHS practice went private, so we had to find another NHS dentist. The nearest we could find was in the next town and the last time we went it cost me £18 in bus fares! That was just another slap in the face for the ‘poor’.” (Survey respondent, Kent)

David Harker, Chief Executive of Citizens Advice said,

"It is not acceptable that so many people are still going without dental care, putting not only their own health but often the health of their families at risk. The Government reforms so far are welcome, but twelve months on they are nowhere near achieving equal access for all. We believe only further investment targeted in the least well-served areas will achieve this.  PCTs now have a statutory duty to provide dentistry services to meet reasonable requirements. This must mean ensuring everyone has local access to this basic health service".

The Gaps to Fill report also identifies that many people did not know the best sources of information to find a dentist. Only one in five had telephoned their Primary Care Trust (PCT) or Patients Advice and Liaison Service (PALS) for help and only half had used the NHS Direct website.  A number of PCTs in areas where access is worst are now holding waiting lists but Citizens Advice is concerned that these are not adequately publicised and their size may underestimated the scale of the problem. The report says better information across to the public is desperately needed.

The reforms introduced in April 2006 were accompanied by ring-fenced funding so that if a dentist reduced the amount of NHS work they did, the Primary Care Trust could allocate it somewhere else for dentistry work. However the level of funding did not take into account the pre-existing patchy provision.

NHS dentistry has suffered from many years of under investment. Between 1990 and 2004, NHS spending on dentistry increased by only 9% compared to a 75% overall increase in NHS spending. Citizens Advice is recommending that the Government should increase funding to areas with the poorest access to NHS dentistry as part of the Comprehensive Spending Review.

Case studies

A CAB saw a mother on a low income who had three children. She was unable to find a dentist near to her home and had to travel 13 miles each way. In the previous month she had had to travel to several separate appointments, a total of nearly 80 miles. She had also missed appointments for one child because she didn’t have a car and would have missed picking up her other two children from school. Her child lost a tooth as a result.

A CAB in Wales reported a client in her 80s and on a limited income who had had dentures for 35 years and needed replacements. As she was unable to find an NHS dentist she sought private treatment.  She was very distressed to be faced with a bill of nearly £650.

A CAB in Hampshire reported a single woman who was pregnant and in receipt of income support. She could not find an NHS dentist and was faced with a having to pay a completely unaffordable sum of nearly £1,500 for private treatment. The bureau contacted a local NHS dentist who said they had a six month waiting list of 500 patients. The bureau resorted to contacting a charity for help with the costs of private treatment.

Citizens Advice is participating in the British Dental Association Annual Conference being held on 28 March 2007

* Department of Health figures released 23.3.07 state 55.7% of the population received dental treatment in the 24 months to Dec 2006, the same figure as the 24 months leading up to March 2006.

**The survey ran on the Citizens Advice New windowwww.adviceguide.org.uk website from May to November 2006. More than 4,000 people responded. Percentages on some responses do not add up to 100% as people could give more than one answer.

Gaps to fill: CAB evidence on the first year of the NHS dentistry reforms

Notes to editors

  1. The Citizens Advice service comprises a network of local bureaux, all of which are independent charities, and national charity Citizens Advice. Together we help people resolve their money, legal and other problems by providing information and advice and by influencing policymakers. For more information in England and Wales see www.citizensadvice.org.uk
  2. The advice provided by the Citizens Advice service is free, independent, confidential, and impartial, and available to everyone regardless of race, gender, disability, sexual orientation, religion, age or nationality. For online advice and information see New windowwww.adviceguide.org.uk
  3. Citizens Advice Bureaux in England and Wales advised 2.1 million clients on 7.1 million problems from April 2010 to March 2011. For full 2010/2011 service statistics see: www.citizensadvice.org.uk/press_statistics
  4. Out of 22 national charities, the Citizens Advice service is ranked by the general public as being the most helpful, approachable, professional, informative, effective / cost effective, reputable and accountable. (nfpSynergy’s Brand Attributes survey, May 2010).
  5. Most Citizens Advice service staff are trained volunteers, working at around 3,300 service outlets across England and Wales.